Abstract | OBJECTIVES: To characterise peak cardiac troponin levels, in patients presenting with acute myocardial infarction (AMI), according to their comorbid condition and determine the influence of peak cardiac troponin ( cTn) levels on mortality. METHODS: RESULTS: 330 367 patients with ST elevation myocardial infarction and non-ST elevation myocardial infarction were identified. Adjusted peak cTn levels were significantly higher in patients with CKD (adjusted % difference in peak cTnT for CKD=42%, 95% CI 13.1 to 78.4) and significantly lower for patients with COPD, previous angina, previous MI and CHF when compared with patients without the respective comorbidities (reference group) (cTnI; COPD=-21.7%, 95% CI -29.1 to -13.4; previous angina=-24.2%, 95% CI -29.6 to -8.3; previous MI=-13.5%, 95% CI -20.6 to -5.9; CHF=-28%, 95% CI -37.2 to -17.6). Risk of 180-day mortality in most of the comorbidities did not change substantially after adjusting for peak cTn. In general, cTnI had a stronger association with mortality than cTnT. CONCLUSIONS: In this nationwide analysis of patients presenting with AMI, comorbidities substantially influenced systemic concentrations of peak cTn. Comorbid illness is a significant predictor of mortality regardless of peak cTn levels and should be taken into consideration while interpreting cTn both as a diagnostic and prognostic biomarker.
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Authors | Varun Sundaram, Kieran Rothnie, Chloe Bloom, Rosita Zakeri, Jayakumar Sahadevan, Ajay Singh, Toshiyuki Nagai, James Potts, Jadwiga Wedzicha, Liam Smeeth, Daniel Simon, Adam Timmis, Sanjay Rajagopalan, Jennifer Kathleen Quint |
Journal | Heart (British Cardiac Society)
(Heart)
Vol. 106
Issue 9
Pg. 677-685
(05 2020)
ISSN: 1468-201X [Electronic] England |
PMID | 32102896
(Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Copyright | © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ. |
Chemical References |
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Topics |
- Aged
- Aged, 80 and over
- Biomarkers
(blood)
- Comorbidity
- Female
- Humans
- Male
- Middle Aged
- Myocardial Infarction
(blood, mortality)
- Retrospective Studies
- Survival Rate
(trends)
- Troponin
(blood)
- United Kingdom
(epidemiology)
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